D-dimer, P-selectin, and microparticles: Novel markers to predict deep venous thrombosis: A pilot study

John E. Rectenwald, Daniel D. Myers, Angela E. Hawley, Christopher Longo, Peter K. Henke, Kenneth E. Guire, Alvin H. Schmaier, Thomas W. Wakefield

Research output: Contribution to journalArticlepeer-review

129 Scopus citations

Abstract

Current plasma markers for diagnosis of deep venous thrombosis (DVT) allow for exclusion of the diagnosis, but lack adequate specificity to establish the diagnosis. Thus, a prospective study was performed to determine the sensitivity and specificity of plasma assays for D-dimer, soluble P-selectin (P-selectin), and total microparticles in patients with documented DVT by duplex ultrasound. Three groups of individuals were examined: 30 normals; 22 positive for DVT on duplex ultrasound (Group 2); and 21 symptomatic, but negative on duplex ultrasound for DVT (Group 3). Group I individuals had D-dimer values of 1.53±0.12 mg/l and P-selectin values of 0.34±0.05 ng/mg total protein. Group 2 vs. Group 3 individuals had D-dimer values of 7.57±2.03 vs. 3.19±0.79 mg/l, p=0.02; P-selectin values of 0.98±0.11 vs. 0.55±0.08 ng/mg total protein, p<0.01; and microparticle values of 129±17% vs. 99±12% of control, p=ns. Using a logistic regression model with dichotomous variables, we determined a sensitivity of 73%, specificity of 81%, and accuracy of 77% when combining D-dimer, soluble P-selectin, and total microparticles to differentiate Group 2 from Group 3 patients. Logistic regression using continuous variables yielded similar results (p=0.05). This study demonstrates that plasma markers for DVT can be developed and achieve moderate sensitivity and specificity in diagnosing DVT. However for clinical applicability, the sensitivity/specificity will need to be improved. These studies also suggest the importance of soluble P-selectin in assessing DVT in humans.

Original languageEnglish (US)
Pages (from-to)1312-1317
Number of pages6
JournalThrombosis and Haemostasis
Volume94
Issue number6
DOIs
StatePublished - Dec 2005

Keywords

  • Clinical study
  • D-dimer
  • Deep venous thrombosis
  • Microparticles
  • P-selectin

ASJC Scopus subject areas

  • Hematology

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